Concussions, traumatic brain injury (TBI), and their long-term effects are a widespread problem: almost 3 million people visit emergency rooms with some form of traumatic brain injury each year (1, 2). It is surprising then that there aren’t many conventional treatments to help heal the brain, mitigate long-term effects, or even successfully treat symptoms without side effects. Functional medicine, however, has provided relief for many people through a variety of treatments that often include pulsed electromagnetic field (PEMF) therapy, dietary changes, and Omega-3 and CBD supplementation.
Traumatic Brain Injury and Concussions
A traumatic brain injury is any disruption in normal brain function. The most common causes of direct trauma are falls, bumps, blows, or an object penetrating the skull (2, 3). Jolts from any rapid acceleration and then deceleration, such as whiplash or blast injuries, can cause TBI. Cerebrospinal fluid surrounds our brain, cushioning and protecting it from contact with the hard skull. While many falls, bumps, and jolts happen each day and don’t result in trauma, any time the brain touches the skull it can cause a wide range of issues. Blood vessels can tear, nerve fibers can pull, or the brain itself can be bruised (2). While severity varies, any form of TBI is serious and needs attention quickly.
One of the most common and more “mild” forms of traumatic brain injury is a concussion. About 1 in 1,000 people experience concussions, most commonly those 75+ years old, 15-24 years old (due to sports), and children ages 0-4 (2, 3, 4). Symptoms of concussions include (2):
Headache
Memory loss, usually around the time of the injury
Double or blurry vision
Dizziness or imbalance
Nausea or vomiting
Ringing ears
Sensitivity to light
Difficulty concentrating
Trouble falling asleep or sleeping too much
Loss of smell or taste
While many concussions will go away with proper rest and care, sometimes swelling or other adverse effects can occur after the initial injury (2). More severe cases of concussions and traumatic brain injury can also cause symptoms such as motor dysfunction, severe sensory changes, cognitive changes (shortened attention span, overstimulation, distractedness), difficulty understanding or following directions, confusion, or even difficulty expressing words or thoughts (2).
While the severity of the injury often determines the timeline for healing, most concussion symptoms will subside in about 1-3 weeks (5). However, some people find that their symptoms may last anywhere from one month to many years (5).
Post-Concussion Syndrome and Other Long-Term Effects
When symptoms of a concussion last far beyond the usual recovery period, it is called post-concussion syndrome (PCS). Those who experience PCS exhibit several concussive and neurological symptoms that affect their ability to function well. About 10% of teens experience long-term symptoms, and up to 30% of people in other age groups will as well (5). There are four main aspects that PCS can affect: physical health, sleep, cognitive functioning, and mood and behavior (5).
Physical health effects often show up as a continuation of the symptoms experienced during the acute phase of the injury. Headache, dizziness, nausea, sensitivity to light or noise, vision changes, ringing in ears, and fatigue are all commonly reported by those with PCS (5, 6). Sleep is another factor that is often affected. Many people have insomnia, and interestingly, others report sleeping too much (5, 6).
Cognitive function changes can include short-term memory loss, either specifically around the time of injury or general poor memory (5). Trouble concentrating or multi-tasking, as well as slower processing, are other effects seen in post-concussive syndrome. Unfortunately, the neurological symptoms do not stop there. Traumatic brain injuries can affect mood and behavior, resulting in anxiety, panic attacks, depression, irritability, and even drastic mood changes such as irrational anger or increased sadness (5).
More severe traumatic brain injuries can also create disorders outside of the range of PCS, especially if the person sustains more than one concussion or injury. Seizures, sleep disorders, neurodegenerative diseases, and neuroendocrine dysregulation are among the most commonly reported (6).
There is still ongoing discussion about the cause of long-term symptoms, as well as what makes someone more likely to develop PCS. Some physicians believe that PCS has roots in physical, structural damage to the brain, or even messaging system disruption and malfunction. Others believe that it is related to psychological factors, given that many of the symptoms of PCS overlap with mood disorders such as depression, anxiety, and PTSD (6). And while there isn’t a significant quantity of evidence to link the risk of developing PCS to many specific factors, some research has linked a higher chance to those with a history of physiological conditions. These include depression, anxiety, and PTSD, as well as less severe forms of emotional or mental factors, such as significant sources of stress, poor coping skills, and inadequate social support (6).
Treatment Options for Brain Injuries and PCS
Although scientists and physicians have done an incredible amount of research on the brain, there is still quite a bit that we don’t know. While there are some set treatments for concussions, many people still do not find total relief, especially for more severe types of traumatic brain injury and many long-term symptoms.
Rest is always the first and most important treatment option for healing any brain injury. After that, the main route of conventional treatment is symptom management (1, 6). While some people may find that conventional medications can help to treat pain, mood changes, and sleep disorders, many others are looking for ways to treat their symptoms, not just reduce their effects. Omega-3 fatty acids, diet changes, pulsed electromagnetic field therapy, and CBD have helped many of our clients to find healing.
Omega-3 Fatty Acids
Omega-3 fatty acids from fish are amazing for your brain! Not only does research suggest that high doses of omega-3 are heavily associated with improved cognitive performance and recovery after a brain injury, but regular consumption may help reduce the risk of severe trauma when injured (7, 8)! Since traumatic brain injuries cause tissue damage and affect blood flow, they may cause undue oxidative stress to develop in the brain. Omega-3 fatty acids help increase a protein called brain-derived neurotrophic factor (BDNF), which combats oxidative stress, improves cell survival, and encourages cell regeneration (7). Because the body can’t produce many forms of Omega-3s, it is important to include sources in your diet, such as fatty fish and good quality supplements.
Dietary Changes
Many other foods and supplements can also improve brain health after a brain injury. Adding in more vitamin E (found in oils, nuts, and spinach) can improve antioxidant levels (9). Antioxidants work to mitigate the effects of free radicals, which inhibit proper neuronal function. Vitamin E also has a positive impact on brain neuronal health, meaning that neurons function better, live longer, and work more efficiently (9). Curcumin, found in turmeric, has similar effects. Research correlates curcumin intake with reduced concussive symptoms, which leads to better functioning in cognitive tasks (9). This is great news for those suffering from concussions or brain injuries!
Further diet changes can be helpful to mitigate long-term brain injury symptoms. Reducing saturated fats and sugar can go a long way for brain health (9). Because diets heavy with saturated fats reduce BDNF in the brain, limiting fatty red meats, pastries, pies, and cakes, and processed meats and cheeses can all help your brain recover better (9). Alternatively, healthy unsaturated fats and clean ketogenic diets can be extremely helpful in managing symptoms after an acute brain injury.
PEMF Therapy
Pulsed electromagnetic field (PEMF) therapy is a regenerative medicine that focuses on restoring proper energy in our bodies. Amazingly, we all have electricity in our bodies, and each of our cells has a specific charge! If this dips below or above the normal threshold, it can cause any number of issues. PEMF therapy works by resonating a magnetic field on the painful or injured area, creating an energy boost in affected cells. It has helped many people with brain injuries feel better, improve motor function, reduce neuroinflammation, and gain improved neuroprotective effects (10).
CBD Supplementation
Cannabidiol, most commonly referred to as CBD, is another great candidate for combatting the painful or difficult symptoms of brain injuries. CBD is a safe, non-euphoriant, anti-inflammatory analgesic (pain-killer) (11, 12, 13, 14). It is a much safer option for pain management than opioids, NSAIDs, and other addictive or gastrointestinal-damaging pain relief options (12). It exhibits neuroprotective effects, displays antioxidant activity equal to or greater than vitamin E, and inhibits certain types of neurotoxicity (12). Additionally, it can enhance BDNF levels and improve neurogenesis, as well as combat many other negative effects that brain injuries can cause (11). Beyond that, CBD is regularly used to combat symptoms of anxiety, depression, insomnia, and other mood disorders, all of which can be caused by brain injuries (13, 14).
While brain injuries can profoundly affect our lives, there is hope and healing to be had! If you, your child, or your parent has experienced a brain injury and are curious about how functional medicine can help, please contact us to set up an appointment. We can create a treatment plan with the perfect combination of therapies for you, and help you plan and implement sustainable dietary changes if needed. It is our joy to partner together with our patients to find the best treatment options for their specific needs, and we would love to do the same for you.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
info@tcimedicine.com
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Sources:
Centers for Disease Control and Prevention. (2020, August 28). Traumatic Brain Injury / Concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/index.html.
Concussion. (n.d.). https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Concussion#:~:text=Concussions%20can%20be%20caused%20by,like%20in%20a%20war%20zone.
Centers for Disease Control and Prevention. (2020, August 28). Traumatic Brain Injury / Concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/index.html.
NIH Consensus Development Panel on Rehabilitation of Persons With Traumatic Brain Injury. (1999, September 8). Rehabilitation of Persons With Traumatic Brain Injury. JAMA. https://jamanetwork.com/journals/jama/article-abstract/191465.
What is PCS? Resource Center | Concussion Legacy Foundation. (n.d.). https://concussionfoundation.org/PCS-resources/what-is-PCS.
Persistent POST-CONCUSSIVE symptoms (Post-concussion syndrome). (2020, October 6). https://www.mayoclinic.org/diseases-conditions/post-concussion-syndrome/symptoms-causes/syc-20353352#:~:text=Persistent%20post%2Dconcussive%20symptoms%2C%20also,problems%20with%20concentration%20and%20memory.
Kumar, P. R., Essa, M. M., Al-Adawi, S., Dradekh, G., Memon, M. A., Akbar, M., & Manivasagam, T. (2014). Omega-3 Fatty acids could alleviate the risks of traumatic brain injury - a mini review. Journal of traditional and complementary medicine, 4(2), 89–92. https://doi.org/10.4103/2225-4110.130374
Pu, H., Jiang, X., Wei, Z., Hong, D., Hassan, S., Zhang, W., … Chen, J. (n.d.). Repetitive and Prolonged Omega-3 Fatty Acid Treatment after Traumatic Brain Injury Enhances Long-Term Tissue Restoration and Cognitive Recovery. Cell Transplantation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531869/.
9Gomez-Pinilla, F., & Kostenkova, K. (2008). The influence of diet and physical activity on brain repair and neurosurgical outcome. Surgical neurology, 70(4), 333–336. https://doi.org/10.1016/j.surneu.2008.05.023
Miller, C. P., Prener, M., Dissing, S., & Paulson, O. B. (2020). Transcranial low-frequency pulsating electromagnetic fields (T-PEMF) as post-concussion syndrome treatment. Acta neurologica Scandinavica, 142(6), 597–604. https://doi.org/10.1111/ane.13300
Singh, J., & Neary, J. P. (2020). Neuroprotection Following Concussion: The Potential Role for Cannabidiol. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 47(3), 289–300. https://doi.org/10.1017/cjn.2020.23
Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. https://doi.org/10.2147/tcrm.s1928
Tambaro, S., & Bortolato, M. (2012). Cannabinoid-related agents in the treatment of anxiety disorders: current knowledge and future perspectives. Recent patents on CNS drug discovery, 7(1), 25–40. https://doi.org/10.2174/157488912798842269
de Mello Schier, A. R., de Oliveira Ribeiro, N. P., Coutinho, D. S., Machado, S., Arias-Carrión, O., Crippa, J. A., Zuardi, A. W., Nardi, A. E., & Silva, A. C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & neurological disorders drug targets, 13(6), 953–960. https://doi.org/10.2174/1871527313666140612114838